1. Field of the Invention
This invention relates the treatment of burns, open sores, incisions and wounds in mammals. In particular it relates to topical wound therapeutic formulations containing a hyaluronic acid (hyaluronan) and a serine protease inhibitor, preferable in combination with elements found in amniotic fluid.
2. Description of the Prior Art
Adult wound repair is characterized by fibrosis, scarring, and sometimes by contracture. The results of this deforming process affect every form of surgery and can have devastating consequences. In contrast fetal wound healing proceeds without such fibrosis or scar formation, Michael T. Longaker, M.D., Ernie S. Chiu, B.S., N. Scott Adzick, M.D., Michael Stern, D.D.S., Michael R. Harrison, M.D., and Robert Stern, M.D., Studies in Fetal Wound Healing, V. A Prolonged Presence of Hyaluronic Acid Characterizes Fetal Wound Fluid, Ann Surg, April 1991, pp. 292-296.
It is known that hyaluronic acid bonds with fibronectin and together they have a powerful effect on the body's cellular matrix. It is also known that urea, produced by the fetus has an effect on cell migration. Elements such as glucose, protein, sodium, potassium, calcium, magnesium, phosphate and chloride that form the amniotic fluid, work together with an inseparable bond and synergy.
Fibronectin is important in wound healing. However, the presence of certain proteases in excess binds with the fibronectin and prevents its activity in healing.
Several prior art patents disclose therapeutic formulations including hyaluronic acid. Lindblad, "Hyaluronic Acid Preparation used for Treating Inflammations of Skeletal Joints"; U.S. Pat. No. 4,801,619 disclosed the use of hyaluronic for intra-articular administration for the treatment of steroid arthropathy and progressive cartilage degeneration caused by protoglycan degradation. Langerman, "Spare Parts for Use in Ophthalmic Surgical Prodecures: U.S. Pat. No. 4,888,016 disclosed the use of hyaluronic acid in ophthalmic surgery as an artificial "spare part" for surgical implantation in the eye during an extracapsular cataract extraction. Alvarez, "Three Step Wound Treatment Method and Dressing Therefor"; U.S. Pat. No. 4, 813,942, which is herein incorporated by reference, disclosed the use of hyaluronic acid in the third step of a three step treatment. The invention calls for hyaluronic acid to be in a hydrocolloid dressing which will provide controlled delivery over a period of 24 to 96 hours to promote thickening of the epidermal cells, thus strengthening the wound. Balazs et al, "Cross-Linked Gels of Hyaluronic Acid and Products Containing Such Gels"; U.S. Pat. Nos. 4,582,865, 4,636,524 and 4,636,865 disclosed the use of cross linked gels of hyaluronic acid as a drug delivery system.
None of these prior art references claim to use hyaluronic acid and a serine protease inhibitor in the treatment of burns, open sores, incisions, and wounds and there is no combination with calcium, phosphate, uric acid, urea, sodium, potassium, chloride, and magnesium to simulate amniotic fluid.
U.S. Pat. Nos. 5,190,917 and 5,290,762, which are herein incorporated by reference disclose the roles of serine protease inhibitors in treatment of inflammation.
U.S. Pat. No. 4,970,298 which is herein incorporated by reference discloses a biodegradable matrix which comprises collagen, hyaluronic acid and fibronectin which enhance healing of wounds. Collagen, which is oversecreted by the body in response to an injury or wound, is known to be responsible for scar formation. Georgalas et al., "Skin Treatment Composition and Method for Treating Burned Skin," U.S. Pat. No. 4,839,019, discloses a composition which counteracts moisture loss and promotes healing of burned or sunburned skin comprised of polyglycerylmethacrylate, glycerine, allantoin, panthenol, amino acid complex, and fibronectin.